Archives of Osteoporosis

, Volume 6, Issue 1–2, pp 39–49 | Cite as

Normative calcaneal quantitative ultrasound data for the indigenous Shuar and non-Shuar Colonos of the Ecuadorian Amazon

  • Felicia C. MadimenosEmail author
  • J. Josh Snodgrass
  • Aaron D. Blackwell
  • Melissa A. Liebert
  • Tara J. Cepon
  • Lawrence S. Sugiyama
Original Article



Minimal data on bone mineral density changes are available from populations in developing countries. Using calcaneal quantitative ultrasound (QUS) techniques, the current study contributes to remedying this gap in the literature by establishing a normative data set on the indigenous Shuar and non-Shuar Colonos of the Ecuadorian Amazon.


The paucity of bone mineral density (BMD) data from populations in developing countries partially reflects the lack of diagnostic resources in these areas. Portable QUS techniques now enable researchers to collect bone health data in remote field-based settings and to contribute normative data from developing regions. The main objective of this study is to establish normative QUS data for two Ecuadorian Amazonian populations—the indigenous Shuar and non-Shuar Colonos. The effects of ethnic group, sex, age, and body size on QUS parameters are also considered.


A study cohort consisting of 227 Shuar and 261 Colonos (15–91 years old) were recruited from several small rural Ecuadorian communities in the Upano River Valley. Calcaneal QUS parameters were collected on the right heel of each participant using a Sahara bone sonometer. Three ultrasound generated parameters were employed: broadband ultrasound attenuation (BUA), speed of sound (SOS), and calculated heel BMD (hBMD).


In both populations and sexes, all QUS values were progressively lower with advancing age. Shuar have significantly higher QUS values than Colonos, with most pronounced differences found between pre-menopausal Shuar and Colono females. Multiple regression analyses show that age is a key predictor of QUS while weight alone is a less consistent determinant. Both Shuar males and females display comparatively greater QUS parameters than other reference populations.


These normative data for three calcaneal QUS parameters will be useful for predicting fracture risk and determining diagnostic QUS criteria of osteoporosis in non-industrialized populations in South America and elsewhere.


Bone mineral density Shuar Colonos Calcaneal ultrasound Developing country 



We express gratitude to Ruby Fried, Michael Fernandez, Betsy Ruth, Paula Tallman, Cesar Kayap, Oswaldo Mankash, Luzmila Jempekat, Estela Jempekat, and Marilu Utitiaj for their assistance with data collection. We also thank our funding sources: Wenner-Gren Foundation for Anthropological Research (Grant number: 7970); NSF (Grant number: BCS-0824602); Evonuk Foundation; L.S.B. Leakey Foundation; Ryoichi Sasakawa Young Leaders Fellowship; NIH (5DP1OD000516-5 via UCSB Center for Evolutionary Psychology); University of Oregon. Finally, we express our sincerest gratitude to the participants in this study.




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Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2011

Authors and Affiliations

  • Felicia C. Madimenos
    • 1
    • 2
    Email author
  • J. Josh Snodgrass
    • 1
    • 2
  • Aaron D. Blackwell
    • 1
    • 2
    • 3
  • Melissa A. Liebert
    • 1
    • 2
  • Tara J. Cepon
    • 1
    • 2
  • Lawrence S. Sugiyama
    • 1
    • 2
    • 4
  1. 1.Department of AnthropologyUniversity of OregonEugeneUSA
  2. 2.Institute of Cognitive and Decision SciencesUniversity of OregonEugeneUSA
  3. 3.Department of Anthropology, Integrative Anthropological SciencesUniversity of CaliforniaSanta BarbaraUSA
  4. 4.Center for Evolutionary PsychologyUniversity of CaliforniaSanta BarbaraUSA

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